The Worst of History: The Spanish Flu (La Enfermedad de 1918)

The First World War stands as one of the deadliest anthropogenic events (events originating from humans) of all time, with as many as 22 million people dying globally—an average of over 10,000 deaths per day. What may have been even deadlier, however, was the 1918 influenza pandemic. With the highest estimate at 100 million deaths, it potentially wiped out over 5% of the global population in just two years. This was the Spanish Flu.

What Is the Spanish Flu?

The Spanish Flu is considered the second-deadliest pandemic in human history, caused by the spread of the H1N1 influenza A virus. It emerged toward the end of World War I and lasted into the early 1920s.

Despite its name, Spain was not the epicentre. The name arose because Spain, a neutral nation during WW1, was one of the few countries that freely reported on the outbreak. Both the Central Powers and Entente Powers suppressed reports to maintain morale. In reality, the earliest recorded cases appeared in Kansas, USA.

Different countries even gave the pandemic alternative names depending on historical context.

“The Angel of Death Spread His Wings”

Symptoms of the virus varied, but often included high fever, diarrhoea, earaches, vomiting, and extreme fatigue.

Dark spots would appear on the skin before it turned blue or purple due to oxygen deprivation. Victims often suffocated on their own fluids, sometimes bleeding from the nose and ears. As US Army doctor Roy Grist observed:

“It is only a matter of hours until death comes and it is simply a struggle for air until they suffocate.”

By mid-1918, the flu had spread to Africa and Asia, then quickly reached Japan, Australia, and India. Unlike typical influenza outbreaks, the Spanish Flu killed not only infants and the elderly but also healthy adults between 20–40 years old—many of them war-weary soldiers.

The second wave in late 1918 proved the deadliest. October alone saw nearly 300,000 deaths in the US. India suffered catastrophic losses, with up to 20 million deaths in just the last quarter of 1918. In the US, 195,000 people died in one month, and national life expectancy dropped by 12 years.

As historian Dr. Mary Dobson explained:

“This virus killed more people in the first 25 weeks than HIV/AIDS has killed in 25 years… horrendous. And those mortality statistics are staggering.”

Pregnant women suffered disproportionately, and many children born during this period faced life-long disabilities—notably Rosemary Kennedy, later institutionalised after a lobotomy.

Cases & Reactions

Munch’s Self-Portrait With Spanish Flu. (Photo courtesy of Lasker Foundation)

World leaders were not spared. Survivors included US President Woodrow Wilson, British Prime Minister David Lloyd George, Spain’s King Alfonso XIII, and Germany’s Kaiser Wilhelm. Notable cultural figures such as Walt Disney and Gandhi also survived.

One haunting artistic record is Edvard Munch’s Self-Portrait with Spanish Flu.

But many were not so fortunate. Victims included sociologist Max Weber (56), Brazilian Prime Minister Francisco de Paula Rodrigues Alves (70), and Austrian painter Gustav Klimt (55).

Quack cures abounded: quinine, iodine, and even smoking were recommended. Spanish doctor Professor Sacone falsely claimed to have isolated the germ. In truth, the H1N1 strain was only identified in 1943, and its genetic sequence not fully mapped until 2005.

More outlandish theories suggested gas clouds from Germany or contaminated aspirin manufactured by Bayer.

Comparisons to Covid-19

The Spanish Flu is often compared to Covid-19. While not identical, some parallels are striking.

Masks: In 1918, the Red Cross recommended masks “to halt the exhaling and inhaling of the influenza germ.” “Mask slackers” could be fined $5. Similarly, during Covid-19, WHO and CDC promoted mask-wearing.
Disinfecting: Spanish papers praised Germany’s disinfecting practices. A century later, hand-washing and sanitiser became compulsory.
Isolation: With no vaccines or antibiotics, public gatherings—schools, churches, theatres—were shut down in 1918, just as they were in 2020.

Workers were forced to wear masks.
(Photo courtesy of The New Yorker)

Minimisation of the threat also echoes across both pandemics. In 1918, Philadelphia Health Director Wilmer Krusen insisted, “No concern whatever is felt.” In 2020, Donald Trump publicly dismissed the need for masks.

There are even potential geographic links. While Covid-19 is thought to have originated in Wuhan, some scholars suggest the Spanish Flu may have started with a 1917 respiratory illness in China. Curiously, China recorded lower mortality during the Spanish Flu—perhaps due to early immunity.

Another eerie similarity: Covid-19 surged globally in 2020, with lockdowns beginning in March and devastation peaking in April. The Spanish Flu finally faded… in April 1920. Coincidence, perhaps, but a striking parallel in history.

Epilogue

It is sobering to realise that the Spanish Flu killed more people than the First World War—perhaps three times as many.

WW1 deaths: ~22 million globally, ~116,000 Americans.
Spanish Flu deaths: 17–100 million globally, 675,000 Americans.

To put that in perspective: all 20th-century US soldier deaths totalled 619,000—fewer than those lost to the Spanish Flu.

In today’s world, Covid-19 has already left a permanent impact. But it pales in comparison to the grim devastation of the 1918 pandemic.

As Dr. Barbara K. Rimer reflected:

“The 1918 influenza pandemic was a cataclysmic event, and the entire world was upended by a terrible health crisis.”

The WHO has warned another influenza pandemic is inevitable. We do not know when, what strain, or how severe—but history has shown it will happen.

The Spanish Flu remains a chilling reminder of humanity’s vulnerability, a global terror unmatched until our modern age.

Take it seriously. Learn from the past.

The Worst of History: Series Recap

For now, this marks the end of our Worst of History series. We’ve travelled through centuries of cruelty, disaster, and devastation — from ancient horrors to modern atrocities — highlighting some of the darkest chapters humanity has endured (and sometimes inflicted).

While this may be the stopping point for the moment, here’s everything we’ve covered so far: